Device for controlled endoscopic penetration of injection needle

ABSTRACT

An endoscopic needle device comprises a handle and a catheter sheath connected to the handle, wherein the catheter sheath has at least one lumen, for example a needle lumen and a stabilization lumen, extending therethrough. A needle is selectively movable within the needle lumen between a needle retracted position and a needle extended position and a stabilization element is selectively movable within the stabilization lumen between a stabilizer retracted position and a stabilizer extended position. A linking mechanism may operatively connect the needle and the stabilization element so that when the needle is in the needle retracted position the stabilization element is in the stabilizer extended position and when the needle is in the needle extended position the stabilization element is in the stabilizer retracted position.

FIELD OF THE INVENTION

[0001] The present invention relates to endoscopic needle devices, andin particular relates to an endoscopic needle device allowing forcontrolled penetration of an injection needle.

BACKGROUND INFORMATION

[0002] Endoscopic needle devices are used for a variety of applications,including fine needle aspiration to collect cell cultures, injectionschelerotherapy to stop bleeding, and sub-mucosal injection of salinefor EMR imaging. Current endoscopic needle devices used for these andother purposes typically consist of an actuation handle, a flexiblecatheter sheath, and a rigid metal needle. While current endoscopicneedles are generally adequate for penetration of soft tissues, knowndevices may have difficulty penetrating tough legions and tumors.Because the application of force by the operator occurs outside thebody, the force may not be entirely transferred to the injection site.Accordingly, the needle may be unable to apply enough pressure at thesite to achieve penetration. Moreover, even if the needle does penetratethe site, the depth of penetration cannot be readily controlled. Forknown embodiments of endoscopic needle devices, this latter drawbackexists for soft tissue penetration as well as for harder tissues.

[0003] In addition, many legions, tumors, or other injection sites arerelatively inaccessible or hard to reach. These sites may require somemanipulation or stabilization of the intended site. Known endoscopicneedle devices do not provide stabilization of the site to effectpenetration in many situations, much less stabilization that would allowcontrolled penetration of the needle.

SUMMARY OF THE INVENTION

[0004] In an exemplary embodiment, the present invention is directed toan endoscopic needle device, comprising a handle and a catheter sheathconnected to the handle, wherein the catheter sheath has at least onelumen extending therethrough. A needle is selectively movable within thelumen between a needle retracted position and a needle extended positionand a stabilization element is selectively movable within the lumenbetween a stabilizer retracted position and a stabilizer extendedposition.

BRIEF DESCRIPTION OF THE DRAWINGS

[0005]FIG. 1 is a side view of an exemplary embodiment of an endoscopicneedle device according to the present invention, including a firstexemplary embodiment of a stabilization element according to the presentinvention;

[0006]FIG. 2 is a side view of a second exemplary embodiment of anendoscopic needle device according to the present invention;

[0007]FIG. 3 is a side view of a third exemplary embodiment of anendoscopic needle device according to the present invention;

[0008]FIG. 4 is a side view of a fourth exemplary embodiment of anendoscopic needle device according to the present invention;

[0009]FIG. 5 is a side view of a distal end of the endoscopic needledevice of FIG. 1 including a second exemplary embodiment of astabilization element according to the present invention;

[0010]FIG. 6 is a side view of a distal end of the endoscopic needledevice of FIG. 1 including a third exemplary embodiment of astabilization element according to the present invention;

[0011]FIG. 7 is a side view of a distal end of the endoscopic needledevice of FIG. 1 at a penetration site, with the stabilization elementof FIG. 1 in an extended position;

[0012]FIG. 8 is a side view of the distal end of the endoscopic needledevice of FIG. 1 at a penetration site, with the stabilization elementof FIG. 1 in a retracted position;

[0013]FIG. 9 is a side view of a fifth embodiment of the endoscopicneedle device according to the present invention including a fourthexemplary embodiment of a stabilization element according to the presentinvention;

[0014]FIG. 10 is a side view of an exemplary embodiment of a valvearrangement and linking mechanism for the needle device of FIG. 9;

[0015]FIG. 11 is a side view of the endoscopic needle device of FIG. 9being employed to penetrate a lesion;

[0016]FIG. 12 is a side view of a distal end of the endoscopic needledevice of FIG. 1 including a fifth exemplary embodiment of astabilization element according to the present invention; and

[0017]FIG. 13 is a side view of a sixth exemplary embodiment of a needlepenetration device according to the present invention having anexemplary embodiment of a needle penetration window according to thepresent invention.

DETAILED DESCRIPTION OF THE INVENTION

[0018]FIG. 1 illustrates an exemplary endoscopic needle device 101according to the present invention. The needle device 101 includes, forexample, a handle 103 connected to a catheter sheath 105 (the termcatheter sheath is intended to include any sort of catheter or similartubular member). The catheter sheath 105, which extends from a proximalend coupled to the handle 103 to a distal end, will typically be aflexible member, but may be completely or partially rigid if suitable.The catheter sheath 105 has at least one lumen extending therethrough.In the exemplary embodiment of FIG. 1, the catheter sheath 105 includes,for example, a pair of lumens extending axially therethrough, a needlelumen 127 and a stabilization lumen 125. The needle lumen 127 andstabilization lumen 125 terminate at openings located, for example, atthe distal end of the catheter sheath 105 (the distal end being locatedto the right in each of the Figures).

[0019] A needle 107 extends, for example, through the needle lumen 127from a needle base 115 disposed in the handle 103, to a needle head 111which, in an extended position, protrudes from the distal end of theneedle lumen 127. In a retracted position, the needle head 111 may becompletely received within the needle lumen 127. A needle hub 121 mayalso be attached to the needle 107 at, for example, the needle base 115.The needle hub 121 is disposed, for example, outside the proximal end ofthe handle 103. Inside the handle 103, the needle 107 may be retained inplace by retaining members 123. Those skilled in the art will understandthat alternate arrangements may be used to retain the needle 107 inconjunction with or in place of retaining members 123.

[0020] A stabilization wire 108 is provided, for example, within thestabilization lumen 125. The stabilization wire 108 extends, forexample, from a wire base 113 disposed in the handle 103, to astabilizing element which, in an extended position, protrudes from thedistal end of the stabilization lumen 125. In a retracted position, thestabilizing element may be completely received within the stabilizationlumen 125, if suitable. In the exemplary embodiment of FIG. 1, thestabilizing element is in the form of a loop 109 which is shaped, forexample, as a circular or ovoid wire element which, in an operativeposition, is placed around an injection site. Loop 109 may be formed,for example, by bending an extension of the stabilization wire 108 backaround upon itself and attaching the extension to the stabilization wire108. Those skilled in the art will understand, however, that anysuitable stabilizing element or elements may be used, and that thepresent invention should not be limited to the embodiments pictured inthe Figures and described herein. Likewise, in FIG. 1 the stabilizationlumen 125 extends into the handle, but other means of retaining thestabilization wire 108 inside the stabilization lumen 125 may beemployed.

[0021] In the exemplary embodiment of FIG. 1, needle 107 andstabilization wire 108 are, for example, linked by a linking mechanism,although the linking mechanism may be omitted in other embodiments,including several embodiments described below. When present, the linkingmechanism coordinates the movement of the needle 107 and stabilizationwire 108 so that as one of the two elements is extended the other of theelements retracts, for example by a corresponding amount. Any suitablelinking mechanism may be employed. In the embodiment of FIG. 1, forexample, needle base 115 and wire base 113 have teeth extending alonginner sides thereof (i.e., the sides facing each other). The teethinterconnect, for example, with gear 117. In this manner, needle base115, wire base 113, and gear 117 form a rack-and-pinion arrangement thatprovides smooth, controlled movement of the needle 107 and stabilizationwire 108 whereby motion of the needle by a predetermined distanceproximally causes a corresponding motion of the stabilization elementdistally with the ratio of motion being determined based on the distancebetween the teeth of the needle base 115 as compared to the distancebetween the teeth of the wire base 113.

[0022] At least one of the needle base 115 and the wire base 113 mayextend outside the handle 103, or be connected to a component which isoutside the handle 103, so that the needle 107 and stabilization wire108 may be easily manipulated by the operator. In the exemplaryembodiment of FIG. 1, the wire base 113 is connected to a control tab119. The control tab 119 may be shaped, for example, in the form of athumb loop designed to fit around the thumb of the operator. When thecontrol tab 119 is urged distally by the operator, the stabilizationwire 108 (along with the stabilizing element) will extend distally(assuming, for example, that the control tab 119 is attached to the wirebase 113). At the same time, if a linking element is present then theneedle 107 and needle head 111 will retract, i.e. move proximally, intothe needle lumen 127.

[0023]FIG. 2 illustrates a second exemplary embodiment of a needledevice 101 according to the present invention in which only a singlelumen is provided. It should be understood that the needle 107 and thestabilization wire 108 need not be maintained in separate lumens.Rather, in certain situations it will be advantageous for the needle 107and stabilization wire 108 to be located within a single lumen. This maybe true, for example, when very narrow vessels or body lumens whereinthe profile size of a deployed endoscope may be small, requiringinstrumentation and, correspondingly, a catheter sheath 105 havingrelatively thin cross-sections. As can be seen in FIG. 2, a needledevice 101 according to this embodiment of the present invention issimilar to the embodiment of FIG. 1. However, the exemplary embodimentof FIG. 2 includes a single lumen 126 in which the needle 107 andstabilization wire 108 are maintained. It may be seen that the cathetersheath 105 of the embodiment of FIG. 2 is of smaller cross-section thanthe catheter sheath of FIG. 1, but this is not required. In general, thecatheter sheath 105 in any embodiment may be of any suitable width. Itshould also be understood that while the remaining Figures typicallyillustrate a dual-lumen arrangement, a single-lumen arrangement may beemployed with other embodiments of the present invention, including theexemplary embodiments described below.

[0024]FIG. 3 illustrates a third exemplary embodiment of a needle device101 according to the present invention. In this embodiment, movement ofthe needle 107 and stabilization wire 108 are, for example, not linked.Rather, the needle 107 and stabilization wire 108 may be activatedindependently, each being movable to any position regardless of theposition of the other. Accordingly, needle base 115 and wire base 113(if present) do not, for example, contain any teeth.

[0025] In some situations it may be preferable to provide partiallinkage between the needle 107 and stabilization wire 108. In theexemplary embodiment of FIG. 4, for example, the needle base 115 andwire base 113 are provided with teeth along a portion of an inner side.In this manner, stabilization wire 108 can be partially retracted, orneedle 107 partially extended, without causing movement of the othermember. When the stabilization wire 108 or needle 107 reaches a certainpoint, however, the teeth of the wire base 113 or needle base 115contact, for example, gear 117. If the other of the wire base 113 andneedle base 115 is also contacting the gear, it will move in thedirection opposite movement of the first element.

[0026] As noted above, any suitable stabilizing element may be employed.FIGS. 5 and 6 illustrate additional embodiments of stabilizing elementsthat may be used in conjunction with the present invention. FIGS. 5 and6 each illustrate the distal end portion of a needle device according tothe present invention, including, for example, needle lumen 127, needle107 with needle head 111, stabilization lumen 128, and stabilizationwire 108. FIG. 5 illustrates a stabilization element in the shape of abarb 139. The barb 139 may be shaped, for example, as a longitudinalmember having one or more backward facing barb elements. The barb 139may be used, for example, to puncture the injection site. When thestabilization wire 108 and barb 139 are retracted, the barb elementswill embed in the site and draw the site towards the needle device 101.Alternatively, the barb 139 may be, for example, scraped against theinjection site to draw the site towards the needle device 101.

[0027]FIG. 6 illustrates a third exemplary embodiment of a stabilizationmember according to the present invention. The stabilizing member ofFIG. 6 is shaped, for example, as a J-hook 149. The J-hook 149 may beextended, for example, beyond and around an injection site. Whenretracted, the J-hook 149 will wrap around, and possibly puncture, theinjection site, thereby achieving a stable hold on the site. Thoseskilled in the art will understand that the J-hook 149 may also includeone or more barb elements as shown in FIG. 5 to provide additionalstabilization.

[0028]FIGS. 7 and 8 illustrate the operation of the needle device 101 ofFIG. 1 in greater detail. The operation is illustrated with the needledevice employing, for example, a loop 109 as the stabilization element.FIG. 7 shows the distal end of the needle device 101 with loop 109 in anextended position placed, for example, around an injection site.Assuming for example that a linkage mechanism is present, the with loop109 in the extended position, the needle 107 is in a retracted position.In this position, the needle head 111 may be contained entirely withinneedle lumen 127. However, those skilled in the art will understand thatother arrangements may be employed for shielding the needle head 111while the loop 109 is in the extended position.

[0029] Once the stabilization element is in place around the injectionsite and the site is stabilized, loop 109 may be retracted. When theloop 109 is retracted, as shown in FIG. 8, the injection site is drawntowards the needle device 101. At the same time, the needle 107 extendsso that the needle head 111 penetrates the injection site (againassuming linkage). The device may preferably be configured so that whenthe loop 109 reaches a fully retracted position, the needle reaches afully extended position, in which the needle head 111 achieves itsmaximum penetration of the injection site. Once suitable penetration hasbeen achieved, the needle 107 may be retracted (as shown in FIG. 7).Those skilled in the art will understand that the needle 107 and needlehead 111 may be extended and retracted numerous times, so that, ifdesired, the needle head 111 will penetrate the injection site numeroustimes. The loop 109 may then be withdrawn from around the injectionsite, and the needle device 101 may be removed.

[0030] Accordingly, a method of use of the needle device 101 accordingto the present invention includes, for example, the following steps. Theneedle device 101 is inserted and delivered to the injection site. Oncethe needle device 101 has been positioned at the injection site, thestabilization element is activated to stabilize the site. This mayinvolve looping a loop 109 or J-hook 149 around the site, scraping abarb 139 along the site or thrusting a barb 139 into the site,positioning a grasper around the site (as discussed below), applying avacuum to the site (as discussed below), or applying some other sort ofstabilization element. With the stabilization element activated, theneedle may be extended. If a linkage mechanism is present, then thepenetration site may be drawn towards the needle device 101 as theneedle 107 is extended. Finally, the injection site is penetrated by theneedle 107.

[0031] FIGS. 9 to 11 illustrate another exemplary embodiment of anendoscopic needle device 101 according to the present invention. In thisembodiment, the needle device 101 includes a vacuum hood 159 as thestabilization element. The hood 159 is, for example, a substantiallycylindrical member having a substantially cylindrical channel 160therethrough. The interior diameter of the channel 160 is, for example,substantially equivalent to the outer diameter of catheter sheath 105.The proximal end of the hood 159 may then be placed over the distal endof the endoscopic needle device 101 or the catheter sheath 105, the twomembers being attached at the overlap section. If desired, the hood 159may instead be integral with the needle device 101 or catheter sheath105 rather than a separate, attached member. The hood 159 is arranged,for example, so that the needle head 111 may extend into the channel 160of the hood 159 when in the extended position.

[0032] As shown in FIG. 11, the stabilization lumen 125 of thisembodiment need not contain any stabilization wire 108 or stabilizationmember. Rather, the stabilization lumen 125 may simply be connected to avacuum (not shown), so that a vacuum can be drawn through the channel160. The term vacuum is intended to include a partial or full vacuum, aswell as any vacuum-creating device, system, or arrangement that may beconnected to the stabilization lumen 125 to create a partial or fullvacuum therein. The vacuum may be linked to the extension of the needle107 (for example via a piston or valve arrangement) or may be controlledindependently of the needle 107. In either case, the control tab 119 isnot connected to the wire base 113 in this embodiment, but instead isconnected, for example, to a vacuum base 166 as shown in FIG. 10 or tothe needle base 115. The vacuum base 166 may, for example, have the sameor substantially the same shape as wire base 113.

[0033] An exemplary valve arrangement for connecting the stabilizationlumen 125 to a vacuum is shown in FIG. 10. The arrangement includes avacuum base 166 connected to a piston 162. The vacuum base 166 may beconnected to a control tab 119, and may form part of a linkingmechanism, as described above with respect to wire base 113. Vacuum base166 and piston 162 are movable, for example, between extended andretracted positions. In the extended position, the piston 162 blocksvacuum lumen 164 which is connected to a vacuum. Thus in this positionno vacuum is established in the stabilization lumen 125 or vacuum hood159. In the retracted position, however, the piston 162 does not blockthe vacuum lumen 164. In this position, a vacuum will be established inthe stabilization lumen 125 and vacuum hood 159, drawing the injectionsite into channel 160. Those skilled in the art will understand that thevacuum lumen 164 or the connection between vacuum lumen 164 andstabilization lumen 125 may be shaped (e.g. widened) so that as thepiston 162 is retracted a vacuum is gradually established in thestabilization lumen 125 and vacuum hood 159.

[0034] In operation, the needle device 101 with vacuum hood 159 isextended to the desired injection site. Once at the site, the vacuum maybe applied to draw the injection site into the channel 160, as shown inFIG. 11. As the vacuum is applied, or after the vacuum has been applied,the needle 107 may be extended so that the needle head 111 enters thechannel 160 and penetrates the injection site. Once the needle head 111has adequately penetrated the site, the needle 107 can be retracted andthe vacuum terminated. The needle device 101 may then be removed fromthe site. As in the embodiments described above, it will be understoodthat the needle head 107 may be extended and retracted a number of timesprior to the removal of the needle device 101.

[0035]FIG. 12 illustrates another exemplary embodiment of astabilization element in operation. In this embodiment, thestabilization element, generally referred to as a grasper 169, includesfor example, a plurality of longitudinal hook elements 170 extendingdistally from the needle device 101. The hook elements 170 extendsubstantially axially from the stabilization wire 108, but in anunbiased position also extend slightly radially outwardly as they extenddistally, as shown in FIG. 12. When retracted into the stabilizationlumen 125, for example, the hook elements 170 may be forced inwardly sothat all of the hook elements 170 fit inside the stabilization lumen125. When extended outside the stabilization lumen, however, the hookelements may spring back to their slightly outwardly extending position.

[0036] The distal tips of hook elements 170 bend back inwardly andproximally, for example, toward the needle device 101. When grasper 169is extended over an injection site, the hook elements 170 are urgedoutwardly by the tissue of the injection site. The hook elements 170therefore exert an inward force on the injection site so that the benttips of the hook elements 170 frictionally engage or puncture theinjection site, as shown in FIG. 12. The grasper 169 may then beretracted to draw the injection site toward the needle device 101. Atthe same time, needle 107 may be extended until needle head 111penetrates the injection site. As with the embodiments described above,the needle 107 may be extended and retracted multiple times, if desired.After sufficient penetration has been achieved, the grasper 169 may beseparated from the injection site (for example by twisting), and theneedle device 101 withdrawn.

[0037]FIG. 13 illustrates a further exemplary feature of a needle device101 according to the present invention. In this embodiment, the handle103 includes, for example, a penetration window 133. The penetrationwindow 133 provides an operator with visual access to, for example, theneedle base 115, the needle itself, or another component connected tothe needle that may act as a visual depth gauge. In this embodiment, theneedle 107 may extend, for example, through a longitudinal channel inthe needle base 115 to the needle hub 121. The outer surface of theneedle 107 and the inner surface of needle base 115 may be threaded, forexample. When the needle hub 121 is rotated, the needle 107 and needlehub 121 move, for example, proximally or distally with respect to theneedle base 115, depending on which direction the needle hub 121 isrotated.

[0038] In this manner, a maximum penetration depth may be establishedfor the needle head 111. This maximum penetration depth may be adjusted,for example, by rotating the needle hub 121 until the desired depth hasbeen established. The maximum penetration depth may be determined, forexample, according to the position of the depth gauge in relation to aset of penetration depth markers 137 appearing on the outside of thehandle 103. The depth markers 137 may be arranged so that when theneedle 107 is in an initial position, for example the fully retractedposition, the position of the needle base 115 relative to the depthmarkers 137 indicates, for example, the maximum penetration depth ofneedle head 111.

[0039] It may be understood that other arrangements of the needle 107and the needle hub 121 will allow for adjustment of the needle 107. Forexample, the needle hub 121 may be fixed to the needle base 115 orhandle 103, for example, with respect to the axial direction (i.e.capable of rotational but not axial movement). The needle hub 121 mayalso include, for example, a channel therethrough having threads on aninner surface that cooperate with threads on a threaded portion of theneedle 107. When the needle hub 121 is rotated, the needle 107 will beextended or retracted, thereby altering the maximum penetration depth.This embodiment may or may not include a needle base 115 or otherelements described above.

[0040] Although the present invention has been described with respect toseveral exemplary embodiments, those skilled in the art will understandthat there are many other variations of the above described embodimentswithin the teaching of the present invention, which is to be limitedonly by the claims appended hereto.

What is claimed is:
 1. An endoscopic needle device, comprising: ahandle; a catheter sheath connected to the handle, the catheter sheathhaving at least one lumen extending therethrough; a needle selectivelymovable within the at least one lumen between a needle retractedposition and a needle extended position; and a stabilization elementselectively movable within the at least one lumen between a stabilizerretracted position and a stabilizer extended position.
 2. The endoscopicneedle device according to claim 1, wherein the stabilization element isa loop.
 3. The endoscopic needle device according to claim 1, whereinthe stabilization element is a barb, the barb being a substantiallylongitudinal member having at least one backward slanting barb elementdisposed thereon.
 4. The endoscopic needle device according to claim 1,wherein the stabilization element is a J-hook.
 5. The endoscopic needledevice according to claim 1, wherein the stabilization element is agrasper, the grasper including a plurality of flexible longitudinalmembers which, when in the stabilizer retracted position, extendsubstantially parallel to an axis of the catheter sheath and, in thestabilizer extended position, extend distally along the axis andoutwardly from the axis, each of the longitudinal members having aninwardly-bent distal tip.
 6. The endoscopic needle device according toclaim 1, wherein the at least one lumen includes a needle lumen and astabilization lumen, the needle being at least partially disposed withinthe needle lumen and the stabilization element being at least partlydisposed within the stabilization lumen.
 7. The endoscopic needle deviceaccording to claim 6, wherein the stabilization element is a loop. 8.The endoscopic needle device according to claim 6, wherein thestabilization element is a barb, the barb being a substantiallylongitudinal member having at least one backward slanting barb elementdisposed thereon.
 9. The endoscopic needle device according to claim 6,wherein the stabilization element is a J-hook.
 10. The endoscopic needledevice according to claim 6, wherein the stabilization element is agrasper, the grasper including a plurality of flexible longitudinalmembers which, when in the stabilizer retracted position, extendsubstantially parallel to an axis of the catheter sheath and, in thestabilizer extended position, extend distally along the axis andoutwardly from the axis, each of the longitudinal members having aninwardly-bent distal tip.
 11. The endoscopic needle device according toclaim 1, further comprising a linking mechanism operatively connectingthe needle and the stabilization element so that movement of one of theneedle and the stabilization element through a first selected rangecauses the other of the needle and the stabilization element to movethrough a second selected range.
 12. The endoscopic needle deviceaccording to claim 11, wherein the linking mechanism operativelyconnects the needle and the stabilization element so that when theneedle is in the needle retracted position the stabilization element isin the stabilizer extended position and when the needle is in the needleextended position the stabilization element is in the stabilizerretracted position.
 13. The endoscopic needle device according claim 12,the linking mechanism comprising: a needle base disposed within thehandle, the needle base being connected to the needle, wherein aplurality of teeth are formed along an inner side of the needle base; awire base disposed within the handle opposite the needle base, the wirebase being connected to the stabilization element via a stabilizationwire, wherein a plurality of teeth are formed along an inner side of thewire base facing the inner side of the needle base; and a gearoperatively connected between the needle base and the wire base, whereinthe needle base, the wire base, and the gear form a rack-and-pinionarrangement, so that when the needle base moves in a distal direction,the wire base moves in a proximal direction, and when the needle basemoves in the proximal direction, the wire base moves in the distaldirection.
 14. The endoscopic needle device according to claim 13,wherein the stabilization element is a loop.
 15. The endoscopic needledevice according to claim 13, wherein the stabilization element is abarb, the barb being a substantially longitudinal member having at leastone proximally slanting barb element disposed thereon.
 16. Theendoscopic needle device according to claim 13, wherein thestabilization element is a J-hook.
 17. The endoscopic needle deviceaccording to claim 13, wherein the stabilization element is a grasper,the grasper including a plurality of flexible longitudinal memberswhich, when in the stabilizer retracted position, extend substantiallyparallel to an axis of the catheter sheath and, in the stabilizerextended position, extend distally along the axis and outwardly from theaxis, each of the longitudinal members having an inwardly-bent distaltip.
 18. The endoscopic needle device according to claim 13, furthercomprising a control tab connected to the wire base and extendingoutside the housing.
 19. The endoscopic needle device according to claim18, wherein the control tab includes a thumb loop.
 20. The endoscopicneedle device according to claim 1, further comprising: a substantiallylongitudinal needle hub rotatably coupled to the handle, wherein achannel extending substantially longitudinally through the needle hubincludes a threaded surface, wherein an outer surface the needle isthreadably coupled to the threaded surface of the channel so that, whenthe needle hub is rotated in a first direction, the needle movesdistally to increase a maximum penetration depth of the needle and, whenthe needle hub is rotated in a second direction opposite the firstdirection, the needle moves proximally to decrease the maximumpenetration depth of the needle.
 21. The endoscopic needle deviceaccording to claim 20, wherein the handle includes a depth gauge forindicating a depth of maximum needle penetration and a penetrationwindow for allowing visual access to the depth gauge, the maximumpenetration depth being determinable based on a position of the depthgauge within the penetration window.
 22. An endoscopic needle device,comprising: a handle; a catheter sheath connected to the handle, thecatheter sheath having a needle lumen and a stabilization lumenextending therethrough; a needle selectively movable within the needlelumen between a needle retracted position and a needle extendedposition; and a vacuum hood disposed at a distal end of the cathetersheath.
 23. The endoscopic needle device according to claim 22, furthercomprising a valve arrangement, selectively connecting the stabilizationlumen to a source of negative pressure.
 24. The needle device accordingto claim 23, the valve arrangement comprising: a vacuum lumen connectedto the stabilization lumen; and a piston movable between a pistonextended position in which the piston blocks a connection between thevacuum lumen and the stabilization lumen and a piston retracted positionin which the connection between the vacuum lumen and the stabilizationlumen is at least partially unblocked.
 25. The needle device accordingto claim 24, further comprising: a needle base disposed within thehandle, the needle base being connected to the needle and having aplurality of teeth disposed along an inner side thereof; a vacuum basedisposed within the handle opposite the needle base, the vacuum basebeing connected to the piston and having a plurality of teeth disposedalong an inner side thereof so that the vacuum base teeth face theneedle base teeth; and a gear operatively connected between the needlebase teeth and the vacuum base teeth, the needle base, the vacuum base,and the gear forming a rack-and-pinion arrangement, so that, when theneedle base moves distally, the vacuum base moves proximally and thepiston moves towards the retracted position and, when the needle basemoves proximally, the vacuum base moves distally and the piston movestowards the extended position.
 26. A method of injecting a needle intoan injection site using an endoscopic needle device, the endoscopicneedle device including a handle, a catheter sheath connected to thehandle, a stabilization element disposed at a distal end of the needledevice, and a needle disposed at the distal end of the needle device,comprising the steps of: inserting the needle device into a body;delivering the needle device to an injection site; applying thestabilization element to stabilize the injection site; and penetratingthe injection site with the needle.
 27. The method according to claim26, wherein the step of applying the stabilization element includeslooping a loop around the injection site.
 28. The method according toclaim 26, wherein the step of applying the stabilization elementincludes looping a J-hook around the penetration site.
 29. The methodaccording to claim 26, wherein the step of applying the stabilizationelement includes scraping a barb along the surface of the penetrationsite to embed bard elements in the site.
 30. The method according toclaim 26, wherein the step of applying the stabilization elementincludes inserting a barb into the penetration site.
 31. The methodaccording to claim 26, wherein the step of applying the stabilizationelement includes positioning a grasper around the penetration site. 32.The method according to claim 26, wherein the step of applying thestabilization element includes applying a vacuum to the penetrationsite, the vacuum being created within a vacuum hood.
 33. The methodaccording to claim 26, the endoscopic needle device further including alinking mechanism operatively connected to the stabilization element andthe needle, further comprising the following step, which is performedafter the step of applying the stabilization element: drawing theinjection site towards the catheter sheath by withdrawing thestabilization element proximally while simultaneously extending theneedle distally.